Melu Kollupu (The Awakening)
Andhra Pradesh HIV/AIDS convention 2008
Date: 27th Novemeber. 08
Venue: Indira Priyadarshini Hall (Public Gardens)
Time: Panel Discussion started from 3:00 PM - 4:22 PM
The panel members were
Mr. Kailash T Ditya, Joint Director- Targeted Interventions
Mrs. Shailaja, Team Leader, HLFPPT
Dr. Gangaiah, Head HIV/AIDS Division, HLFPPT
Krishna, Suraksha Project
Manohar, Founder, Sangama (NGO), Bangalore
Rex, Ex-President, Sangama (NGO), Bangalore & activist
Vijaya Nair, Udaan (NGO), Mumbai
Yatin Patel, Saathi (NGO), Vijayawada
Agniva Lahiri, Executive Director, PLUS (People Like US), Kolkata
Participants:
Media (Print and Electronic Media)
Staff of APSACS/Alliance/HLFPPT/CDC/CHAI/Partner NGOs/CBOs
Community Members (MSMs)
General population
The panel discussion was kept focused on certain issues as a set of questions
were framed for which the panelists had to answer.
The topic for discussion was: The role of MSMs in implementation of the TI
project through their meaningful participation
Q1) The first question being: What is the scenario of HIV/AIDS in AP, what are
the services available for HIV/AIDS patients and people at risk?
Mr. Manohar said that the problem of HIV/AIDS is very severe in Andhra Pradesh.
As is already known, HIV/AIDS is highly prevalent in 6 states of India, Andhra
Pradesh being one of them. A.P has roughly 1% of the AIDS cases. MSMs are people
who have higher chances of being infected. They are more vulnerable as firstly,
they are not accepted in society because of which they are scared to come out in
the open and avail services offered for them.
Secondly, legal provisions are lacking for MSMs which makes them vulnerable to
law as well. The Targeted Interventions Program is using the community to
implement programs by directly involving them in the implementation process. The
TI program also provides lubricant contraceptives necessary for the community
and Drop-In-Centers are also being provided. The community is also being
encouraged to take up advocacy activities.
Mr. Rex shared that the MSM community has been stigmatized right from childhood.
Because of the stigma and hatred, the community has always faced violence and
harassment throughout life. Discrimination starts right from the family.
Physical & mental harassment is faced which continues throughout life in every
aspect; be it at workplace, on the road or in the family.
This leads to homosexuals, MSMs, Transgender, Cross-dressers believe that they
are not worthy human beings. Who is responsible for this, MSMs or the people who
don’t understand sex & sexuality? Because MSMs are non-confirmative, stigma is
attached to them. This fear that the behavior/preference need to be controlled
as it is un-natural leads to harassment. This attitude threatens the survival of
the community.
Mr. Krishna said that the Community has been working since 20 years in A.P. But
no one has ever shown their face to the media. But today, HIV is posing a severe
threat to the community so they have come out in the open through this program.
The community needs acceptance from all: the society, the media and families.
Mr. Kailash shared that estimates show that there are 48,000 MSMs in AP. Of all
the HRGs, MSMs are the most affected (18% are infected with HIV/AIDS). It is for
this reason that this program has been taken up by TSU and APSACS. The main aim
of the program is to encourage Behavior Change, safer sex practices among the
community and removing the Stigma & Discrimination. The main components of
Targeted Interventions are: Condom Promotion, Provision of STI services,
providing an Enabling Environment. This Program is part of our efforts towards
creating an enabling environment for the community. Thus, the media should give
a positive response
Q2) Keeping the prevalence rates in mind and the Stigma & Discrimination, what
would ideally be the role of MSMs in HIV prevention?
Mr Gangaiah: The community should develop an enabling environment for themselves
to protect themselves in society. Research says that MWSM activity has been in
existence since mankind has existed. Even temple sculptures and our epics talk
about MSM activity. But this activity has never been recognized/ openly
discussed. But with an increase in the number of HIV cases in this population,
the existence of this community has to be recognized. MSM rights also need to be
recognized.
Sec 377 needs to be removed. This section was introduced under the Indian Penal
Code during the British time. There was no scientific reasoning for the activity
then. Now, Biological research shows that MSM preference is natural. However,
consensus is not being gained on this issue and the government is not accepting
the demand to remove this section from the IPC. Sec 377 is obstructing the
rights of MSMs.
Their rights as a human being should be protected. The family and the
police must help them but are not able to because of legal provisions.
Dealing with FSWs is easier than dealing with MSMs because of sec 377. The
police need to be sensitized. While implementing Sec 377, they are violating
Fundamental Rights of MSMs who are also citizens of the country. Thus, because
of stigma, the infection is spreading from MSMs to the general population. So,
we are not able to protect/control the spread to the general population.
Enabling environment should be provided from all perspectives; be it community,
legal, Fundamental Rights or infection prevention perspective.
Mr. Manohar: A discussion is needed on Sexual minorities. The media has an
important role to play in this. Today, women's problems, minoritie's problems
are known to all because of open discussions in media. But, no one discusses
MSMs issues. Media should play a key role as Human rights are being violated.
But, no one is coming out in the open.
Sec 377 has been in the IPC since 135 years now. Then, Christian communities
interpreted MSM activity as wrong. However, this was not a scientific
conclusion. WHO says homosexuality is not wrong or un-natural. Police harassment
is meted out to MSMs who are supposedly doing wrong activities.
Q3) How should we improve the TI programs? Do you think there are any gaps in
the program?
Mr. Yatin Patel: The TI program says that HIV is high amongst MSMs.
This shows that there is a gap. The gap is from both the community side and
program side. It has been 7 years since the program has started being
implemented, but there has been no IEC material even at the NACO level about
safe sex practices. There is no particular focus on oral and anal sex. Most of
the community is hidden and is thus not availing the services. Community has to
ensure that they too are given information to avail such services. Migrant
populations also need to be identified by the community. If the community is not
active, where will they belong? Advocacy has also failed. Sexual behavior change
is necessary. If this component is included, the gap may be filled.
Mr. Arun Chowdhary: The community has a great role to play. No one talks about
human rights. Everyone talks only about sexual health of MSMs. Why should Hijras
live only as Commercial Sex Workers/ beggars?
MSMs don't even know what should be done when they identify this behavior in
themselves. Awareness on what should be done to survive with this preference
needs to be given to the community members. Darpan is going a step ahead in this
way.
Mr. Kailash: Around 4/5 years back, people would't even go to VCTCs/ICTCs.
Because of TIs, and programs such as the Aasha program, Mee Nestam, Behavior
change is seen. Now, people are coming to such centers. APSACS aims at such
behavior change and awareness.
Mr. Gangaiah: The Community can be understood at two levels; the micro-level and
the macro-level. At the micro-level, we see MSMs role in HIV prevention while on
the macro level, we see the involvement of religions, ages and sections of
society. The basic responsibility of the MSMs is to protect themselves from the
infection and then protecting the whole community. Adopting safer sexual
practices and other key issues are covered under the TI program. The larger
community should respect the rights of the community. Their orientation is not
un-natural. Respect their preference and rights. Family should most importantly
support these people.
Q4) what are the obstacles in health and human Rights of MSMs?
Mr. Agniva Lahiri: 10 years ago, NACO said we are a disease control agency.
Yesterday also, in a gathering they said the same thing. If only HIV prevention
is the main aim, then MSM behavior is affected.
MSMs are disadvantaged/poor/ from a minority who have no skills.
Thus, the only option for them becomes to join sex work/hijras.
Today, when the project and the community is standing against atrocities people
say society will be ruined. This fight should be made a more dignified Human
Rights issue which has still not been achieved today.
The HIV/AIDS Bill is being introduced with new provisions. If the government
puts a chip into every human beings body to trace their movements is this not a
human rights violation? The law ministry has suggested tracking HIV/AIDS
patients by putting a chip to trace where the HIV infected person goes and how
the infection is being transmitted.
Tomorrow, the MSM community may also be put through such indignities. The
community needs the media's support against such doings of the government.
Mr. Vijaya Nair: Statistics reveal that 17% of the community is infected with
HIV. Since 14 years, the HIV has existed. Only 1% of the HRG is MSM. The
intervention has reached a stage of saturation.
But in rural areas, MSMs and TGs are not able to avail our services.
Therefore the infection is increasing. To increase prevention, the program has
to be increased, infrastructure, manpower needs to be strengthened along with
Public Private Partnerships and linkages.
Services for HIV positive Hijras and MSMs need to be strengthened so that they
can avail such services without any fear. Tomorrow, India's first DIC is being
inaugurated in AP for counseling. The concept of prevention has to be changed to
Care continuum.
In 10 districts of AP, the figures are more than the 17% that we know of. Today,
rural India has a lot of MSMs. They have been accepted by the society but do not
have services available for them.
Mr. Kailash: The link workers scheme is working in 6 Districts of AP. It will
start working from 1st December in rural areas. This is an initiative by UNICEF
and CCF to facilitate the provision of services in rural areas. The link workers
will cover High Risk Groups in Rural areas. The 6 districts will be on a pilot
basis after which intervention will spread to other districts slowly.
Mr. Rex: Most of the prevention work today is focusing on the sex aspect of the
community. The focus should shift on the community being Human beings like
everyone else.
Ms. Shailaja: Swagathi works in 300 rural areas of 9 Districts of AP.
Safe sex awareness, condom distribution, and provision of STI services,
collectivization and advocacy are being focused on in this program. Advocacy and
collectivization have been encouraged since the last 3 years. MSMs are more
literate than FSWs, they should take the initiative. Till now the program has
been facilitating the community.
The community today is in such a stage as to work independently.
HLFPPT and APSACS will support the community's work so taken up. The duty of the
community is to make themselves more self reliant.
After this discussion a summary was done on what the questions raised were and
what were the responses. Mr. Krishna gave a closing suggestion to the media to
get a complete knowledge before impact goes to the society. The community had
not come out in the open till now. Everyone has a responsibility to create
acceptance in society regarding the community. Nobody is being blamed. Today,
the 1st convention on MSMs has been conducted in AP to bring out the sexuality
of the community in the open.
The stage was then opened for questions. The audience asked questions to the
panel which were answered.
Q) There was a talk about a DIC opening tomorrow. Can that be elaborated?
Mr. Kailash: The 1st DIC is being given to the CBO Darpan for the PLHAs within
the community.
Q) Elaborate on the link workers scheme that shall be started in 6 districts.
Ms. Shailaja: Where the TI program is not able to have complete coverage, UNICEF
and CCFF are trying to help in reach ability. These link workers will be for
youth, migrants. Services will be started off by reaching out to at least 50
FSWs, MSMs. This will be piloted in the 6 districts after which they will slowly
be started in other areas as well.
Mr. Manohar: This scheme will basically be to fill the gap of inaccessibility of
rural areas.
Q) There has been news that 20 ICTC/mobile vans gave been released from APSACS.
In Ananthapur, of 64 mandals, there are only 15 VCTCs.
The inception of the ICTC mobile vans would be a good idea as people are not
able to access services from such a less number of VCTC centers; Would these
vans be for the use of all or only accessible at PHCs and GGHs?
Ms. Shailaja: The mobile vans have started last month. Figures and total
information shall be given in consultation with APSACS. Only some districts have
this mobile van currently.
Q) Why did you do this program today? Was it to bring awareness about the
community or for recognition of MSMs?
Mr. Krishna: Firstly, the increase in HIV cases in MSMs has led us to conduct
this program. This increase is basically because of stigma from society, family.
To be able to use the services that are available, they have to come out in the
open. Hence, to encourage MSMs by the community coming out in the open, we also
aim at reducing the incidence of HIV/AIDS.
Q) What is your opinion about Sec 377?
Mr. Krishna: Under Sec 377, nowhere has same-sex been mentioned. MSMs are being
dragged under Sec 377.
Mr. Manohar: This Section is outdated. The court should not decide what is
natural or un-natural. Morals should not be forced upon an individual. Above the
age of 18 years, any sex by choice should not be stopped. This Section is
violating the Right to Privacy, the Right to health and the right to life.
Q) Are there any MSM clubs, legal help organizations like the ones in Karnataka?
Mr. Manohar: In AP, we are trying to bring a legal help Organization like
Sangama of Bangalore.
Mr. Arun Chowdhary: In Srikakulam, there was an incident wherein an engineering
college fresher was ragged by a senior. The junior was forced to have sex with
the senior. This was taped and the media got hold of the video clip. It was
shown on TV and news channels. The mother of the boy who was ragged was
continuously asked about her son's sexual preference which led her to commit
suicide. The whole family, unable to bear the harassment shifted to Vizag.
This incident was the basis on which Darpan was formed. Today, Dapran is working
for legal rights of MSMs. The Tamil Nadu Government has set up an Aravani
Collective Board which deals with the legal issues of MSMs
After these discussions, the vote of thanks was delivered to all participants
and panel members who came and succeeded the program.
Durga Prakash Yerramasetti
Asst Director (TI)
APSACS
Mobile: 9849985802
e-mail: <yerramasetti@...>
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